This invention relates to pulmonary exerciser and preoperative and postoperative pulmonary evaluation devices, and more particularly, to pulmonary exercisers operative during both the inhalation and exhalation pulmonary cycles which incorporate quantitative scales and recording devices. These devices incorporate patient incentive features and are designed to motivate the patient to exercise.
Pulmonary exercisers are useful both pre and postoperatively, to help strengthen respiratory musculature, to help restore and maintain lung capacity, to motivate deep breathing, to help clean the lungs during the hospital stays. Further, pulmonary exercisers help prevent postoperative pulmonary complications such as atelectasis or hypostatic pneumonia. For example, periodic deep breathing exercises have been shown to be clinically useful for patients experiencing post surgical pain, inactive, obese, and geriatric patients, and patients with chronic obstructive pulmonary disease.
In view of the extensive utility of pulmonary exercisers, it is a primary object of the present invention to provide an exerciser apparatus which is relatively simple, lightweight, convenient to use, safe and inexpensive, whereby it is available to a relative maximum number of patients.
It is another object of this invention to accomplish the above object by allowing for both inspirator and expiratory exercise with a single unit.
Several types of exercisers are presently available. For example, one class of exerciser is based chiefly on the inspiratory stage of the pulmonary cycle, and includes utilization of bellows, blow bottles, or balls rising in columns. In the latter category, one or more sequential, interconnected columns have free access to the atmosphere at one low extremity, and balls located therein are pulled upwardly therefrom and suspended in the column by the suction effect of the inspiratory flow.
In a second class of exerciser, calibrated resistance is applied to the expiratory force of the patient. An example of this class of apparatus is set forth in U.S. Pat. No. 3,908,987 of J. R. Boehringer, issued Sept. 30, 1975.
In a third class of exerciser, the patient is asked to breathe against a relatively high resistance to expiratory flow contained in a cardboard tube.
In a fourth class of exerciser, the patient is asked to blow water from one bottle to another. This system has serious defects. The water itself may become an infection site, and in any event, this form of exerciser tends to drive the lung alveoli down to low volumes, whereas alveolar expansion also is desired.
It is an object of the present invention to provide apparatus capable of providing both inspiratory and expiratory exercise functions as well as quantifying inspiratory flow rate for certain clinical measurements and records. Correspondingly, in order to avoid danger to the patient, it is an object to provide such dual function without jeopardy to the safety of the patient. In order to minimize the training problem of alternate mouth and nose breathing, it is an object to combine inspiration flow measurement and positive end expiratory pressure (PEEP) connected to the patient by a common channel.
Another problem associated with postoperative exercisers is one which is generally associated with exercise and exercising apparatus: lack of motivation on the part of the user. That is, in nearly all exercise programs, faithful adherence tends to be discouraged by the nature of the exercise program, including the need to monitor repetitions of the exercise, and general inability to monitor the efficiency at which the exercise program is conducted. For pulmonary exercisers, discouragement also is provided in the form of discomfort associated with deep breathing by a patient who has had his chest surgically invaded. In any exercise program, lack of diligence is an undesirable situation, but for a failure diligently to follow a postoperative pulmonary exercise program, the results may be deleterious to the health, recovery, and even life of the patient.
It is accordingly an object of the present invention to provide postoperative apparatus which provides incentive motivation for the patient, whereby repetitive procedures and the efficiency of those procedures may be readily monitored.
It is another object of this invention to provide a pulmonary aid apparatus adapted for both inspiratory and expiratory breathing, with an indicator for providing visual measurement, and with facility for recording.
It is a further object of this invention to provide an inspiratory breathing apparatus with any means for measuring flow, and with a dual recording means, for recording both achievement level, and number of exercises.
It is another object of this invention to provide an inspiratory breathing apparatus that allows continuous measurement of level of achievement (as distinguished from mere measurements of whether or not a level of inspiration has been effected), along with any type of recording of any of various parameters associated with the breathing.
It is still another object of this invention to provide a pulmonary aid apparatus having a demountable base for ease of assembly, disassembly, or packaging.
It is a further object of this invention to provide a flow meter with facility for measuring that is predicated upon visual discontinuities.
It is another object of this invention to provide an inspiratory breathing apparatus with a flow responsive member adapted to seal when there is not flow, in preferably seated engagement.
It is a further object of this invention to provide an expiratory exercise apparatus (PEEP), in which versatility is provided for adjusting the amount of exercise that a patient may get in a given breath.
Other objects and advantages of the present invention will be readily apparent to those skilled in the art from a reading of the following brief descriptions of the drawing figures, detailed descriptions of the preferred embodiments, and the appended claims.